Visitors to Mediterranean beaches have been warned to take precautions against mosquito bites this summer.
Diseases previously only found in the tropics are now infecting tourists and locals in European countries such as Greece, France, Italy and Spain.
This month authorities on the Costa Blanca reported Spain's first case of chikungunya, a mosquito-carried virus that causes fever and joint pain. Three Icelandic tourists became ill after a holiday in Alicante. In November last year a resident of Barcelona reported the region's first case of dengue fever.
The first outbreak of chikungunya in Italy in 2007 caused 217 infections. In 2017, it reappeared with another outbreak of at least 200 illnesses. Outbreaks have also occurred in France in 2010, 2014 and 2017.
Last year, Which? Travel reported that some parts of the Middle East, Asia and Africa are . For health issues, Europe is still relatively low risk, but climate change and increased foreign travel have prompted a rise in new threats.
According to expert Dr James Logan from London's School of Tropical Medicine: 'The mosquito species aedes has now infested most of Europe, with sightings in Belgium, France, Spain and even the UK. It's not something to scaremonger about - risk is still low compared with the tropics - but people should take precautions, particularly with children.'
He advises that, even on Mediterranean beaches, holidaymakers should consider using a repellent with one of the four ingredients recommended by the London School of Hygiene & Tropical Medicine.
While risk of a serious illness is still low, bites can be painful and they can become infected. The names to look out for on the bottle are Deet, PMD, IR3535 or Picaridin. All of these are effective, although the duration of protection varies. It's important to read the instructions provided for how often you need to reapply. Avoid natural remedies such as oil of citronella, which are not been proven to be effective.
The aedes mosquito is believed to have arrived in Europe thanks to its eggs being attached to used tyres transported from South Asia. Milder winters mean that the species is now more likely to survive than in the past.
Travellers in Europe should take particular care at dawn and dusk, when aedes mosquitoes are mostly likely to bite. In the tropics, the more dangerous malaria-carrying mosquitoes typically bite at night.
Other precautionary methods include wearing loose, light-coloured clothing and applying repellent on top of sunscreen, rather than the other way round.
The risk of becoming seriously ill after a mosquito bite is still much higher in the tropics and travellers should check the NHS site for information on the appropriate immunisations and anti-malarial tablets where necessary.